Oasis in the desert: A randomized, community-based trial of nutrition access and education in Florida

INTRODUCTION – Almost 15% of US households experience food insecurity, a state driven by decreased access to, affordability of or knowledge about nutritious foods. Partnering with a community in a USDA “food desert” in Alachua County, FL, we seek to determine the impact of nutrition education coupled with increased access to nutritious foods versus increased access alone. METHODS – Within a randomized community-based trial, 100 participants have been assigned to (A) nutrition education and improved access or (B) improved access only for 12 weeks. In participatory fashion, intervention components were designed from iterative focus group feedback. Access has been improved by (1) partnering with local convenience store and farmers to provide in-store farmer's kiosks, (2) providing half-price vouchers for purchase of these foods, and (3) building gardens with the participants. For one group, interactive and applied education classes are held in a local community center, store and kitchen. Both groups receive weekly support and assistance from a health coach. Fruit and vegetable consumption and psychosocial measures of attitudes, social support, self-efficacy, and barriers surrounding nutritional behaviors will be collected longitudinally. In addition, health literacy and quality of life changes will be assessed. RESULTS – Changes in behaviors and psychosocial scores will be presented. Due to a community-participatory approach, we expect to provide evidence of improved quality of life and social capacity sustained beyond study conclusion. DISCUSSION – Building from high levels of community engagement, this study provides strong internal validity to inform allocation of resources in underserved, food insecure neighborhoods.